Provider Demographics
NPI:1598089054
Name:DOMINGO C BARRIENTOS MEDICAL CLINIC INC.
Entity Type:Organization
Organization Name:DOMINGO C BARRIENTOS MEDICAL CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINGO
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRIENTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-869-1322
Mailing Address - Street 1:10800 PARAMOUNT BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3331
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10800 PARAMOUNT BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-3331
Practice Address - Country:US
Practice Address - Phone:562-869-1322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
G39494Medicare UPIN